Longitudinal associations between early-life fluoride exposures and cardiometabolic outcomes in school-aged children.

BACKGROUND/AIM: Fluoride is a natural mineral present in food, water, and dental products, constituting ubiquitous long-term exposure in early childhood and across the lifespan. Experimental evidence shows fluoride-induced lipid disturbances with potential implications for cardiometabolic health. However, epidemiological studies are scarce. For the first time, we evaluated associations between repeated fluoride measures and cardiometabolic outcomes in children. METHODS: We studied âˆ¼ 500 Mexican children from the Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS) cohort with measurements on urinary fluoride at age 4, and dietary fluoride at ages 4, 6, and 8 years approximately. We used covariate-adjusted linear mixed-effects and linear regression models to assess fluoride associations with multiple cardiometabolic outcomes (ages 4-8): lipids (total cholesterol, HDL, LDL, and triglycerides), glucose, HbA1c, adipokines (leptin and adiponectin), body fat, and age- and sex-specific z-scores of body mass index (zBMI), waist circumference, and blood pressure. RESULTS: Dietary fluoride intake at age 4 was associated with annual increases in triglycerides [ß per-fluoride-doubling = 2.02 (95 % CI: 0.37, 3.69)], cholesterol [ß = 1.46 (95 % CI: 0.52, 2.39)], HDL [ß = 0.39 (95 % CI: 0.02, 0.76)], LDL [ß = 0.87 (95 % CI: 0.02, 1.71)], and HbA1c [ß = 0.76 (95 % CI: 0.28, 1.24)], and decreased leptin [ß = -3.58 (95 % CI: -6.34, -0.75)] between the ages 4 and 8. In cross-sectional analyses at age 8, higher tertiles of fluoride exposure were associated with increases in zBMI, triglycerides, glucose, and leptin (p-tertile trend < 0.05). Stronger associations were observed in boys at year 8 and in girls prior to year 8 (p-sex interaction < 0.05). Fewer but consistent associations were observed for urinary fluoride at age 4, indicating increased annual changes in HDL and HbA1c with higher fluoride levels. CONCLUSION: Dietary fluoride exposures in early- and mid-childhood were associated with adverse cardiometabolic outcomes in school-aged children. Further research is needed to elucidate whether these associations persist at later ages.

Prenatal maternal phthalate exposures and child lipid and adipokine levels at age six: A study from the PROGRESS cohort of Mexico City.

BACKGROUND: Prenatal phthalate exposures may affect processes that underlie offspring cardiometabolic health, but findings from studies examining these associations are conflicting. We examined associations between biomarkers of phthalate exposures during pregnancy with child lipid and adipokine levels. METHODS: Data were from 463 mother-child pairs in the PROGRESS cohort of Mexico City. We quantified 15 phthalate metabolites in 2nd and 3rd trimester maternal urine samples and created an average pregnancy measure using the geometric mean. We evaluated the 15 metabolites as nine biomarkers, including four metabolite molar sums. We measured fasting serum triglycerides, non-HDL cholesterol, leptin, and adiponectin in children at the six-year follow-up visit (mean = 6.8 years). We estimated associations using linear regression, Bayesian kernel machine regression (BKMR), and weighted quantile sum (WQS) and assessed effect modification by sex. RESULTS: In BKMR and WQS models, higher concentrations of the total mixture of phthalate biomarkers were associated with lower triglycerides (ß = -3.7% [-6.5, -0.78] per 1 unit increase in WQS biomarker index) and non-HDL cholesterol (ß = -2.0 [-3.7, -0.25] ng/ml per increase in WQS biomarker index). Associations between individual biomarkers and child outcomes were largely null. We observed some evidence of effect modification by child sex for mono-3-carboxypropyl phthalate (ß = 19.4% [1.26, 40.7] per doubling of phthalate) and monobenzyl phthalate (ß = -7.6% [-14.4, -0.23]) in girls for adiponectin. CONCLUSIONS: Individual prenatal phthalate biomarkers were not associated with child lipid or adipokine levels. Contrary to our hypothesis, the total phthalate mixture was associated with lower child triglycerides and non-HDL cholesterol.

Factors associated with insufficient weight gain among Mexican pregnant women with HIV infection receiving antiretroviral therapy.

OBJECTIVE: We identified clinical, dietary, and socioeconomic factors associated with insufficient gestational weight gain among Mexican pregnant women with human immunodeficiency virus (HIV) infection. METHODS: This was a cross-sectional study involving 112 pregnant women with HIV infection receiving antiretroviral therapy (ART). Data including viral load, complete blood analysis, and CD4 counts were extracted from medical records. An inquiry form was used to collect data on socioeconomic status and frequency of food intake. Pre-gestational weight was calculated based on pregnancy weight to obtain the body mass index (BMI) and weight gain for gestational age according the US Institute of Medicine. Of the study population, 68.7% were in consensual union, 31.3% were single, and 33.9% belonged to the two lowest socioeconomic strata. The median age and CD4 count were 27 (interquartile range [IQR]: 23-32) years and 418 (IQR: 267-591), respectively. The adequacy of energy was 91.8% (IQR: 74.1-117.7). The median energy intake from protein was 13.5% (IQR: 12.2-14.9) and from lipids, 35.5% (IQR: 31.1-40.3). Pregnant women with gastrointestinal symptoms and CD4 count <350 were seven times more likely to have folate deficiency (odds ratio [OR] 7.8, 95% confidence interval [CI] 1.6-38.1; p = 0.009) and six times more likely to have poor zinc intake (OR 6.7, 95% CI 1.3-36.8; p = 0.014). In all, 42.9% of the pregnant women consumed iron and folic acid supplements and 54.4% consumed multivitamin supplements. Moreover, 45.5% had a normal pre-gestational BMI, 41.1% were classified overweight, and 13.4% had obesity, whereas 62.5% showed insufficient gestational weight gain, and 18.8% experienced weight loss. The variables associated with insufficient weight gain were consensual union (OR 5.3, 95% CI 1.9-15.0; p = 0.002) and belonging to the lowest socioeconomic stratum (E) (OR 3.1, 95% CI 1.0-9.2; p = 0.046). CONCLUSION: Dietary strategies to improve gestational weight gain for Mexican women with HIV infection receiving ART must consider clinical and socioeconomic factors.

Burnout and Metabolic Syndrome in Female Nurses: An Observational Study.

Nurses are at risk of having burnout due to workload and job stress-studies have reported that chronic stress is associated with metabolic syndrome. This study aimed to assess the association between burnout and metabolic syndrome in a sample of female nurses. Data were collected from a cross-sectional study from 2016 to 2018 in a tertiary hospital in Mexico City. All nurses that work in the hospital were invited to participate. Information pertaining to sociodemographic (age, education level), work (labor seniority, service area, shift work), anthropometric (weight, waist circumference, blood pressure) and biochemical (glucose, serum lipids) variables were collected. Burnout was assessed using the Maslach Burnout Inventory test, and metabolic syndrome was defined according to the International Diabetes Federation criteria. A total of 168 nurses participated with a median age of 44 years. The prevalence of burnout and metabolic syndrome was 19.6% and 38.7%, respectively. There was no association between burnout and metabolic syndrome (p = 0.373). However, associations of emotional exhaustion (aOR: 14.95; 95% CI: 1.5-148.7), personal accomplishment (aOR: 0.13; 95% CI: 0.01-0.99), and night shift (aOR: 12.39; 95% CI: 1.02-150.5) with increased waist circumference were found. Strategies are needed to prevent burnout and metabolic syndrome in nurses, especially in those who work at night shift.

"Sacbe", a Comprehensive Intervention to Decrease Body Mass Index in Children with Adiposity: A Pilot Study.

Interventions in children with adiposity decrease less than 0.2 the body mass index (BMI) z-score less than 0.2 and only in 21⁻23% of cases. Experts recommend focusing on the habits of a healthy lifestyle (HLS) but considering the sociocultural context of children and their parents. Our objective was to achieve a higher percentage of success in lowering the BMI z-score in children with adiposity and their parents through a pilot program "Sacbe" based on HLS, sensitive to the sociocultural context previously explored and with the active participation of parents. This is a pilot study in children aged 8 to 18 years with adiposity according to the BMI z-score. The program consisted of two workshops on HLS and nutrition given by the pediatric endocrinologist in group sessions with 3⁻5 families and reinforcements in each visit by registered dietitians. We recorded lifestyle habits and anthropometric characteristics of children and their parents at the baseline visit and every month for 3⁻4 months. Forty-nine families, 55 children and 64 parents participated, 60% of the children were female, the average age was 13.95 ± 3.3 years, 72.7% and 86.7% lowered the z score of the BMI due to intention to treat and protocol analysis (p < 0.001), respectively; BMI z-score decreased by 0.22 ± 0.21, from 2.13 ± 0.57 to 1.91 ± 0.58 (p < 0.001). In total, 83% of the parents involved were mothers, the average age was 45.8 ± 9.4 years, 77% lost weight and body fat (p < 0.001), the frequency of unhealthy habits decreased. The results of "Sacbe" exceeded expectations by combining the active participation of parents, sessions in groups, and the education on various components of an HLS inside sociocultural context. The main challenge will be to standardize and reproduce this type of complex interventions, as well as to assure long-term success.

Association between UCP polymorphisms and adipokines with obesity in Mexican adolescents.

BACKGROUND: It has been reported that the uncoupling proteins (UCPs) can contribute to energy metabolism, and are thus involved in the pathogenesis of obesity. The objective of the study was to analyze the association between UCP polymorphisms, clinical parameters and leptin and adiponectin plasma levels in an adolescent population with overweight and obesity. METHODS: We analyzed the UCP1 -3826 C/T, UCP2-866 G/A, Ala55Val and UCP3 -55 C/T polymorphisms and the levels of adipokines in adolescents with normal weight and with overweight or obesity. The study included 270 students aged between 12 and 18 years categorized according to the percentiles from Mexico City. Adipokines levels were measured by immunoassay methods and the UCP polymorphisms were determined using Taqman real-time polymerase chain reaction (RT-PCR). RESULTS: No significant differences were found in the UCP polymorphisms in seven inheritance models studied. Most of the significant differences in the clinical parameters were found under a recessive model, the UCP2 -866 polymorphism was associated with diastolic blood pressure (p=0.008), triglycerides (p=0.045), low-density lipoprotein-cholesterol (LDL-C) (p=0.003), high-density lipoprotein-cholesterol (HDL-C) (p=0.050) and plasma levels of leptin (p<0.001). Also, the obese group was found to have higher leptin levels and lower adiponectin levels in GA+AA vs. GG (recessive model). CONCLUSIONS: This study demonstrated a direct relationship between the clinical characteristics and UCP2-866 in a recessive model, associated with high levels of leptin and decreased levels of adiponectin in an obese or overweight Mexican adolescent population.

Serum Concentration of Leptin in Pregnant Adolescents Correlated with Gestational Weight Gain, Postpartum Weight Retention and Newborn Weight/Length.

Introduction: Gestational weight gain is an important modifiable factor known to influence fetal outcomes including birth weight and adiposity. Leptin is normally correlated with adiposity and is also known to increase throughout pregnancy, as the placenta becomes a source of leptin synthesis. Several studies have reported positive correlations between cord blood leptin level and either birthweight or size for gestational age, as well as body mass index (BMI). Objective: To determine the correlation of prenatal leptin concentration in pregnant adolescents with their gestational weight gain, postpartum weight retention, and weight/length of their newborn. Methods: A cohort study was conducted on pregnant Mexican adolescents from Gestational Week 26-28 to three months postpartum (n = 168 mother-child dyads). An anthropometric assessment was made of each pregnant adolescent, and the serum level of leptin and the intake of energy were determined. The newborn was evaluated each month during postpartum. Clinical records were reviewed to obtain sociodemographic data. Bivariate correlations, tests for repeating measurements and logistic regression models were performed. Results: Leptin concentration gradually increased during the third trimester of pregnancy. At Gestation Week 36, leptin level correlated with gestational weight gain. When comparing adolescents that had the lowest and highest concentration of leptin, the former presented a mean of 6 kg less in gestational weight gain (inter-subject leptin concentration, p = 0.001; inter-subject energy intake, p = 0.497). Leptin concentration and gestational weight gain exerted an effect on the weight of the newborn (inter-subject leptin concentration for Week 32, p = 0.024; inter-subject gestational weight gain, p = 0.011). Newborn length was associated with leptin concentration at Week 28 (leptin effect, p = 0.003; effect of gestational weight gain, p = 0.722). Conclusions: Pregnant adolescents with leptin concentration over 20 ng/mL showed a greater gestational weight gain. Leptin concentration correlated with length and weight of the newborn.

Biomarcadores óseos y su relación con la densidad mineral ósea en adultas jóvenes y adolescentes en su primer año posparto / Bone biomarkers and its relation with bone mineral density in adults and adolescents during the first year postpartum

La información sobre biomarcadores óseos en adolescentes y adultas durante el periodo posparto es incierta, por lo que el objetivo de este artículo fue analizar el patrón de biomarcadores óseos en adolescentes y adultas a 15, 90, 180 y 365 días posparto (dpp) y su asociación con la densidad mineral ósea (DMO) y lactancia materna. Se realizó un estudio de cohorte en 32 madres adolescentes ≤17 años y 41 adultas de 18 a 29 años de edad en el primer año posparto. Se realizaron medidas antropométricas, DMO y biomarcadores óseos y así como datos del tipo y la duración de lactancia. Como resultados se encontró asociación entre la concentración basal de N-telopéptidos ≤24 μg/L y mayor aumento de DMO. Las adolescentes tuvieron mayor concentración de N-telopéptidos (p≤0.004) y menor concentración de osteocalcina (5±3 vs13±4, p <0.001) que las adultas. La lactancia no afectó el cambio de DMO (p>0.050), ni de biomarcadores óseos. La osteocalcina se asoció con el cambio en DMO (p<0.040). La prolactina fue mayor entre las que practicaron lactancia materna exclusiva (p<0.001). A menor edad menores concentraciones de osteocalcina (p<0.001) y mayores concentraciones de N-telopéptidos (p<0.001). Se concluyó que a menor concentración de N-telopéptidos y mayor de osteocalcina hubo un mayor aumento de DMO, lo cual implica menor aumento de ésta en el grupo de adolescentes. La lactancia no afectó la DMO.

The objective of this study was to describe the trend of bone biomarkers in adults and adolescents women at 15, 90, 180 and 365 postpartum days (ppd) and its relation with bone mineral density (BMD). It was a prospective cohort of 32 teenager’s ≤17 and 41 women from 18 to 29 years old. We evaluated diet, anthropometry, BMD, bone biomarkers and hormonal profile. In all, the concentration of N-telopeptide was higher at 15 days postpartum decreasing during first year postpartum, but adolescents had the highest concentration. The lowest N-telopeptide concentration was associated with highest increasing of the BMD. Osteocalcin concentration was lower in adolescents than in adults women (5 ± 3 vs 13 ± 4 ng/mL, p<0.001) during first year postpartum. Exclusive breastfeeding did not affect the BMD (p>0.050) or bone biomarkers. Osteocalcin concentration was positively associated with bone BMD (p<0.040), breastfeeding did not affect osteocalcin concentrations. Prolactin was higher among women who breastfed exclusively (p<0.001). Age and breastfeeding inversely correlated with bone biomarkers (p<0.001) N-telopeptide and PTHi respectively. We concluded that a lower N-telopeptide concentration and a higher osteocalcin concentration were associated with a higher increasing of BMD, so then, adolescents showed the lowest recovery of the BMD. Breastfeeding does not affect the BMD.

[Bone biomarkers and its relation with bone mineral density in adults and adolescents during the first year postpartum]. / Biomarcadores óseos y su relación con la densidad mineral ósea en adultas jóvenes y adolescents en su primer año posparto.

The objective of this study was to describe the trend of bone biomarkers in adults and adolescents women at 15, 90, 180 and 365 postpartum days (ppd) and its relation with bone mineral density (BMD). It was a prospective cohort of 32 teenager's ≤17 and 41 women from 18 to 29 years old. We evaluated diet, anthropometry, BMD, bone biomarkers and hormonal profile. In all, the concentration of N-telopeptide was higher at 15 days postpartum decreasing during first year postpartum, but adolescents had the highest concentration. The lowest N-telopeptide concentration was associated with highest increasing of the BMD. Osteocalcin concentration was lower in adolescents than in adults women (5 ± 3 vs 13 ± 4 ng/mL, p<0.001) during first year postpartum. Exclusive breastfeeding did not affect the BMD (p>0.050) or bone biomarkers. Osteocalcin concentration was positively associated with bone BMD (p<0.040), breastfeeding did not affect osteocalcin concentrations. Prolactin was higher among women who breastfed exclusively (p<0.001). Age and breastfeeding inversely correlated with bone biomarkers (p<0.001) N-telopeptide and PTHi respectively. We concluded that a lower N-telopeptide concentration and a higher osteocalcin concentration were associated with a higher increasing of BMD, so then, adolescents showed the lowest recovery of the BMD. Breastfeeding does not affect the BMD.

Control prenatal y zinc sérico: su repercusión en el recién nacido de madres adolescentes / Prenatal control and serum zinc: impact on the newborn to adolescent mothers

Introducción: Las adolescentes embarazadas son un grupo vulnerable nutricionalmente porque deben cumplir con sus propias necesidades de crecimiento y las del embarazo. El control prenatal es importante para un consumo de nutrimentos y una resolución del embarazo adecuado. Objetivo: Asociar el trimestre de inicio de control prenatal y el zinc sérico consumido con algunas características neonatales. Material y métodos: Estudio de cohorte, analítico y prospectivo con adolescentes embarazadas que se atendieron en el Instituto Nacional de Perinatología con las siguientes evaluaciones, en el último trimestre gestacional: consumo de zinc (frecuencia de consumo de alimentos), zinc sérico (espectrofotometría), antropométrica (peso, estatura) y revisión del expediente clínico (inicio del control prenatal y datos del neonato). Análisis estadístico: prueba t de Student, χ² de Pearson y regresión lineal. Aprobado por los comités de ética e investigación. Resultados: El 59% de las participantes inició el control prenatal en el primer trimestre gestacional; de ellas, el 56% tuvo parto vaginal, 92% de neonatos fueron a término, 85% con peso adecuado y mayor consumo de zinc. Las concentraciones séricas de zinc a la semana 28 y 32 de gestación explicaron 35% el peso al nacer R² = 0.358, β 2837 IC 1761, 3914, p = 0.001, 16% del perímetro cefálico (R² = 0.163 β = 35 EE = 1.9, IC 31.2, 39, p = 0.001), 25% de la edad gestacional (p = 0.003) y el 43% la longitud al nacer R² = 0.431, β 55.5 IC 49.62, p = 0.001). Conclusiones: El control prenatal en el primer trimestre se asoció a un mayor consumo de zinc. Las concentraciones de zinc sérico normales se asociaron con más frecuencia a neonatos a término y con mayor longitud, peso y perímetro cefálico.

Introduction: Adolescents pregnant are a vulnerable group in the nutritional area because they have their self growth requirements and for the child. Prenatal care is important to achieve healthy nutrition and better pregnant outcomes. Aims: To associate the gestational trimester beginning prenatal care, zinc (Zn) serum concentrations and its intake with neonatal characteristics. Methods: This is a cohort study with pregnant adolescents assisted by Perinatology National Institute. In the last trimester of gestation, we determine anthropometry characteristics, zinc intake (food frequency), serum zinc (espectrofotometry) and clinical records in order to get newborn somatometry. Statistic analysis: T Student, χ² de Pearson and lineal regression. The study was approved by INPer's Research and Ethic Committee. Results: More than 50% adolescents pregnant began their prenatal care at the first gestational trimester, 56% had eutocic part, 92% were at term, and 85% had newborn's normal weight and normal zinc intake. Normal zinc serum concentrations explained 35% of NB weight (R² = 0.358, IC 1761, 3914, p = 0.001), 16% of head circumference (R² = 0.163, IC 31.2, 39, p = 0.001), 25% of gestational age at term (p = 0.003), and 43% of newborn height (R² = 0.431, IC 49.62, p = 0.001). Conclusions: Prenatal care in the first trimester was associated with a higher zinc intake. Zinc normal serum concentration was associated with normal gestational age at term, higher weight, head circumference and height stature.

[Abnormal eating behaviours are not associated with micronutrient deficiencies among women of childbearing age from Mexico City]. / Las conductas alimentarias de riesgo no se asocian con deficiencias de micronutrimentos en mujeres en edad repro- ductiva de la ciudad de México.

The aim of this study was to evaluate the association between the risk of abnormal eating behaviors (AEB) and vitamin and mineral deficiencies among women. Women of childbearing age (n = 282) were systematically sampled with a random start (21.9% adolescents) in 6 suburbs in the west side of Mexico City, they were non pregnant or breastfeeding. Vitamin A, C, E, B12, folic acid, hemoglobin, ferritin, cupper, iron and zinc concentrations were measured. A questionnaire validated in the Mexican population was used for screening AEB. Data were analyzed by descriptive statistics and by using Fisher's test. Approximately 68% of the sample belonged to a mid-low or lower socioeconomic status. 14% had risk of AEB, without statistical differences between adults and teenagers. 10% used diuretics or laxatives to reduce weight within the trimester preceding the survey. Vitamin E, zinc and iron were the most widespread deficiencies affecting 47%, 44% and 27% of the population, respectively. There was no association between the AEB and micronutrient deficiencies neither when AEB were analyzed globally nor individually. Considering these results and the high prevalence of the AEB and overweight in this population, it is important to promote the adoption or healthy behaviors to achieve an adequate weight.

Percepción de la cantidad de flujo menstrual y su asociación con las deficiencias de hierro, ácido fólico y vitamina B12 en mujeres de la ciudad de méxico / Menstrual Bleeding perception and its association with iron, folic acid and vitamin B12 deficiencies among women from mexico city

La anemia de origen nutricio afecta a un tercio de las mujeres en edad reproductiva a nivel mundial y puede deberse a la deficiencia de uno o varios nutrimentos involucrados en la hematopoyesis, principalmente el hierro. Las mujeres constituyen un grupo en riesgo dadas las pérdidas menstruales. Por ello, el objetivo de este trabajo fue evaluar la relación entre la percepción de cantidad de flujo menstrual y las deficiencias de hierro, folato y vitamina B12 en una muestra de mujeres de la Ciudad de México. Se realizó un estudio transversal, con mujeres de 12 a 49 años, no embarazadas ni amamantando. Se midieron las concentraciones de hemoglobina, ferritina, hierro y vitamina B12 en suero y ácido fólico eritrocitario. La cantidad de flujo menstrual percibida se examinó con una escala analógica visual de 10 cm de longitud. Las asociaciones se evaluaron mediante las pruebas T de Student, Chi² y el coeficiente de correlación de Pearson. La sensibilidad y especificidad se representaron en una curva ROC. Los resultados mostraron que las anémicas tuvieron una percepción de la cantidad de flujo menstrual significativamente mayor que las no anémicas (p<0.05). No se observaron diferencias en las calificaciones informadas por las mujeres con deficiencias de otros nutrimentos y aquellas sin deficiencias. La escala analógica visual propuesta en este trabajo puede ser utilizada en poblaciones sanas como una herramienta subjetiva de tamizaje para el riesgo de padecer anemia, que además es fácil de contestar y económica(AU)

Nutritional anaemias affect more than one third of women of reproductive age worldwide as a result of a lack of one or various nutrients involved in the haematopoiesis, mainly iron. Women are at higher risk because of menstruation. The objective of this paper was to evaluate the association between the perception of the amount of menstrual bleeding and iron, folic acid, vitamin B12, ferritin and hemoglobin deficiencies, among women from Mexico City. This cross-sectional study included 12-49 year old women, that were not pregnant or breastfeeding. Hemoglobin, ferritin, iron, folate, and vitamin B12 were quantified. Self reported menstrual bleeding was estimated by using a 10 cm long visual analogue scale. Associations were calculated by Student’s T test, Chi2 and Pearson’s correlation coefficient. Sensibility and specificity were depicted in a ROC curve. Results showed that anaemic women perceived a larger menstrual blood loss than those non anaemic (p<0.05). No differences were observed in any other of the micronutrients studied.The visual analogue scale is an easy-to-answer and cheap screening test that could be used in apparently healthy populations to detect the risk of anaemia(AU)

Las conductas alimentarías de riesgo no se asocian con deficiencias de micronutrimentos en mujeres en edad reproductiva de la Ciudad de México / Abnormal eating behaviours are not associated with micronutrient deficiencies among women of childbearing age from Mexico City

El objetivo de este trabajo fue evaluar la asociación entre las conductas alimentarias de riesgo (CAR) y las deficiencias de vitaminas y nutrimentos inorgánicos en una muestra de mujeres en edad reproductiva. Participaron 282 mujeres de 12 a 49 años (21.9 por ciento adolescentes) no embarazadas ni lactando, muestreadas de manera sistemática con arranque aleatorio en 6 colonias del poniente del Distrito Federal. Se evaluaron las concentraciones de las vitaminas A, C, E, B12 y ácido fólico así como de hemoglobina, ferritina y hierro y zinc séricos. Para las CAR se usó un cuestionario validado en la población mexicana. La información se analizó con estadística descriptiva y la prueba de Fisher. Aproximadamente el 68 por ciento de la muestra fue de nivel socioeconómico medio-bajo o inferior. El 14.8 por ciento tuvo un puntaje de riesgo para las CAR, sin diferencias entre adolescentes y adultas. Las CAR más frecuentes fueron la preocupación por engordar y comer demasiado. El 10 por ciento de las mujeres, aproximadamente, usaron diuréticos o laxantes durante el trimestre anterior a la encuesta. Las deficiencias más importantes fueron las de Vitamina E, zinc y hierro, que afectan al 47 por ciento, 44 por ciento y 27 por ciento de la población, respectivamente. No hubo asociación significativa entre las CAR y las deficiencias de micronutrimentos de manera global ni al analizar por conductas aisladas. A pesar de ello, y dada la alta prevalencia de las CAR y la obesidad en esta población, es necesario hacer campañas para promover la adopción de conductas saludables que permitan alcanzar un peso adecuado.

The aim of this study was to evaluate the association between the risk of abnormal eating behaviors (AEB) and vitamin and mineral deficiencies among women. Women of childbearing age (n=282) were systematically sampled with a random start (21.9 percent adolescents) in 6 suburbs in the west side of Mexico City, they were non pregnant or breastfeeding. Vitamin A, C, E, B12, folic acid, hemoglobin, ferritin, cupper, iron and zinc concentrations were measured. A questionnaire validated in the Mexican population was used for screening AEB. Data were analyzed by descriptive statistics and by using Fisher´s test. Approximately 68 percent of the sample belonged to a mid-low or lower socioeconomic status. 14 percent had risk of AEB, without statistical differences between adults and teenagers. 10 percent used diuretics or laxatives to reduce weight within the trimester preceding the survey. Vitamin E, zinc and iron were the most widespread deficiencies affecting 47 percent, 44 percent and 27 percent of the population, respectively. There was no association between the AEB and micronutrient deficiencies neither when AEB were analyzed globally nor individually. Considering these results and the high prevalence of the AEB and overweight in this population, it is important to promote the adoption or healthy behaviors to achieve an adequate weight.

Vitamin C supplementation to prevent premature rupture of the chorioamniotic membranes: a randomized trial.

BACKGROUND: Vitamin C is involved in the synthesis and degradation of collagen and is important for maintenance of the chorioamniotic membranes. Inadequate availability of ascorbic acid during pregnancy has been proposed as a risk factor for premature rupture of the chorioamniotic membranes (PROM). OBJECTIVE: The objective of the study was to evaluate the effectiveness of 100 mg vitamin C/d in preventing PROM. DESIGN: A controlled double-blind trial was performed. Pregnant women (n = 126) in their 20th wk of gestation were invited; 120 accepted and were randomly assigned to 2 groups (100 mg vitamin C/d or placebo). Every 4 wk, plasma and leukocyte vitamin C concentrations were measured, and each subject was evaluated for cervicovaginal infection. The incidence of PROM was recorded for each group as an indicator of the protective effect of vitamin C supplementation. RESULTS: One hundred nine patients finished the study. Mean plasma vitamin C concentrations decreased significantly throughout the pregnancy in both groups (P = 0.001), and there were no significant differences between groups. Between weeks 20 and 36, mean leukocyte vitamin C concentrations decreased from 17.5 to 15.23 microg/10(8) cells in the placebo group and increased from 17.26 to 22.17 microg/10(8) cells in the supplemented group (within- and between-group differences: P = 0.001). The incidence of PROM was 14 per 57 pregnancies (24.5%) in the placebo group and 4 per 52 pregnancies (7.69%) in the supplemented group (relative risk: 0.26; 95% CI: 0.078, 0.837). CONCLUSION: Daily supplementation with 100 mg vitamin C after 20 wk of gestation effectively lessens the incidence of PROM.